Women reaching equality in health, despite the differences Nowadays women remain the largest CAD population subgroup being under-diagnosed and under-treated despite having the highest risk of mortality and morbidity from CAD.

Facts About Heart Disease in Women Cardiovascular disease is the No. 1 killer of women in the world, causing 1 in 3 deaths each year. In 2012 cardiovascular disease caused deaths in women in the world. That represents deaths per month and deaths daily. In Europe Cardiovascular disease remains the most common cause of death in women and is responsible for 49% of all deaths, almost 1 in 2 deaths each year. Each year 2 million women die in Europe from cardiovascular disease. That represents deaths per month and deaths daily. Almost 4 european women die every minute! Coronary heart disease is the most common single cause of death in women, 10 times more frequently than mortality from breast cancer 20% vs 2%. Almost 1 million women die in Europe from coronary heart disease.

1- Differences In the increasingly ageing population of Europe, women account for the majority of the older citizens. Physical differences exist between the underlying biology in women’s vascular beds compared to those of men. These physical differences may partly justify the increased mortality of women with cardiovascular disease. This excesive mortality observed in women may be due to factors other than physical differences.

2- Lack of equality, causes. Lack of awareness towards ischemic symptoms is one of the most important reasons for delayed presentation in women Late presentation in the clinic is associated with delayed diagnosis and therapeutic procedures The later treatment is performed from symptom onset less myocardial salvage is carried out. Time interval from symptom onset to first physician contact is at least one and half hours longer in women than in men.

3-Lack of equality, reality Women experience delays in identification of the STEMI diagnosis and also in the PCI process. Door to balloon time is higher in women than men. Women are less revascularized under the guideline- recommended time compared to men. This occours mainly during off hours.

3- Lack of equality, reality Cardiac rehabilitation programmes are shown to reduce recurrent cardiac events and related premature death in patients with cardiovascular diseases. Women are significantly underrepresented in cardiac rehabilitation programs with less referral and less completion. It is known when women complete programs, they experience the greatest reduction in mortality compared to men.

4- Lack of equality, results Women undergoing PCI for STEMI have higher mortality than men. Mortality at 1-year follow-up :15.1% vs. 9.3%. Mortality at 4-year follow-up:21.6% vs. 15.0% This excess of mortality could only partially be explained by their physical differences and baseline characteristics.

In order to reduce this lack of equality we should increase awareness about cardiovascular disease in women as well as in men. Increase awareness about cardiovascular disease in women is mandatory in the health community : diagnosis, treatment and referral to Cardiac rehabilitation programmes must achieve equality.